Abstract
Participation is the overarching goal of neurorehabilitation and OT interventions. Despite this emphasis on participation, evidence suggests that people with traumatic brain injury (TBI) have poor participation. It is clear that socioeconomic status has a relationship with other health outcomes, but little is known about its relationship with participation after TBI. The objective of this research was to examine disparities in participation after TBI between household income groups.
Primary Author and Speaker: Alyssa M. Taubert
Additional Authors and Speakers: Kimberly Erler
Contributing Authors: Joseph G. Giacino, Michael Bergin, Amber Thomas, andYelena Bodien
Participation is the overarching goal of occupational therapy interventions; however, evidence suggests that people with traumatic brain injuries (TBI) have poor participation. It is clear that socioeconomic status has a relationship with other health outcomes, but little is known about its relationship with the construct of participation after TBI. Therefore, the objective of this study was to examine disparities in participation after TBI between annual household income (HHI) groups which included <$24,999, $25,000-$49,999, $50,000-$99,999, and >$100,000. We performed a retrospective analysis of the Spaulding-Harvard TBI Model Systems Center data. Participants were community-dwelling adults age 18-80 years old with moderate-severe TBI. Results of the ANCOVAs for each of the Participation Assessment with Recombined Tools-Objective domains (Productivity, Social Relations, Out and About) revealed statistically significant differences between HHI groups [Productivity: F (3, 217) = 8.667, p < .001, partial η2 = 0.107; Social Relations: F (3, 217) = 17.614, p < .001, partial η2 = 0.196, partial η2 = 0.196, and Out and About: F (3, 217) = 6.585, p < .001, partial η2 = 0.083]. Post hoc analyses with Bonferroni correction revealed that the <$24,999 HHI group had significantly worse participation than all other HHI groups on all three domains while the >$100,000 HHI group had greater participation in the Social Relations domain than all other groups. These results suggest that disparities exist in this meaningful outcome of participation based on HHI. OT Practitioners should consider current practices that may contribute to these disparities and explore additional or novel interventions that promote participation for individuals with TBI who have lower HHI.
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